A Case of Methimazole Induced Agranulocytosis Treated with Granulocyte Colony Stimulating Factor ( G-CSF ).
- Author:
Kwan Woo LEE
;
Yoon Sok CHUNG
;
Hyeon Man KIM
;
So Yeon CHOI
;
Min Kyung SONG
;
Hyun Soo KIM
;
Hee Sun JEON
- Publication Type:Case Report
- Keywords:
Agranulocytosis;
Methimazole;
G-CSF
- MeSH:
Adult;
Agranulocytosis*;
Biopsy;
Bone Marrow;
Carteolol;
Colony-Stimulating Factors*;
Female;
Fever;
Granulocyte Colony-Stimulating Factor*;
Granulocytes*;
Graves Disease;
Hospitalization;
Humans;
Lymphocytosis;
Methimazole*;
Mortality;
Neutrophils;
Palatine Tonsil;
Pharyngitis;
Physical Examination
- From:Journal of Korean Society of Endocrinology
1997;12(1):68-74
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 31-year-old woman admitted because of fever, chilling and sore throat for 4 days. The symptom was developed after receiving methimazole 20mg per day and carteolol 10mg per day due to Graves disease during last 4 weeks. Physical examination revealed hyperemic enlarged tonsils with whitish plaque. The peripheral blood total neutrophil count was 1,400/mm3 (absolute neutrophil count, ANC 36) and a peripheral blood smear revealed rare neutrophil with lymphocytosis. On the first day of hospitalization, the patient was severely ill with ANC 0, it was decided to administer G-CSF 2ug/kg daily. On the fifth day of hospitalization, ANC in peripheral blood count was persistently zero and bone marrow aspiration and biopsy were performed, which revealed hypocellularity and myeloid hypoplasia. G-CSF given daily for 7days, it was discontinued when the ANC reached 1,539/mm3. The availability of G-CSF may help to shorten the course of agranulocytosis and to reduce its mortality rate.
